Treatment of Dupuytren's contracture

Dupuytren's contracture - a disease thatcharacterized by the appearance of scar tissue under the skin in the palm of your hand. Which is why there is a change fascia. Scars cover some tendons, providing all the functions of grasping fingers. Over time, education can progress and thicken. Often in the affected areas appear dimpled.

The disease may differ in degreeprogression. In some cases, it occurs with skin wrinkling. The other - the rapid formation of contractures. Often this disease disturbs the patient for many years.

Initially, there is usually painlessa small bump near the base of the fingers. Often the disease affects the ring finger, but it can affect the other. Even once on both hands. With the progression of the disease to bend the fingers becomes more difficult. Sometimes it is developing a complete loss of the ability to take something in hand. In rare cases, the pathology proceeds painful, especially when pulling the affected fingers.

Often the disease is complemented by the appearance of inflammatory process on the toes and thickening of the fascia. In this case the disease has already called plantar fasciitis.


Dupuytren's contracture, fingers, hands, ligaments

To date not yet known the exact cause of this disease. There is an opinion of experts, who say that often this disease occurs in people suffering diabetes. alcoholism and epilepsy. In addition, it is believed that this pathology is passed genetically. But not all people with the gene will inherit the disease.

It is also noted that most illnessIt is seen in men. Sometimes in the medical literature indicate that the cause of this disease is physical overload brushes. But in fact, not at all with such a problem develop Dupuytren's contracture.

In addition, many are of the opinion that trigger the development of the following risk factors for the disease are:

  1. Chronic trauma.
  2. Brachial plexus neuropathy.
  3. Hereditary syndromes.
  4. Inflammatory diseases of the joints.
  5. Eating disorders and exchange tendons.
  6. Nerve entrapment hands.
  7. Acute or chronic infectious process.

These reasons are not proved by physicians, but to some extent may contribute to the formation of disease.


Dupuytren's contracture, fingers, hands, ligaments

Usually when viewed visually determinedforced position of the fifth finger. In this case, it is bent at the metacarpophalangeal joint and the first relative to the main phalanx is located at right angles. In patients with the diagnosis of skin roughness is also found in the area of ​​the distal folds his hand.

During probing hand, ifpathology, found seal palmar fascia. These dense knots patient can determine at even yourself. First, they usually appear in the palm of your hand, and eventually spread to the fingers.

After probing is usually determined by the amplitude,which unbend and bend the fingers on a hand. In the presence of the disease mobility of one or more fingers is reduced, and in severe cases, their movement becomes practically impossible. It is for the mobility of the patient's fingers determine the stage of disease. The most common diagnosis for no additional examination is necessary.

When the diagnosis is established, necessarilyto exclude traumatic, neurogenic, rheumatic and ischemic contracture which often develop as a result of injuries, gunshot wounds, open fractures, and as a result of damage to the muscles and tendons. A person with Dupuytren's contracture such injuries are usually absent.


Dupuytren's contracture, fingers, hands, ligaments

Depending on the stage and complexity of the diseaseboth conservative and surgical treatment is possible. At the initial stages, conservative therapy is quite effective. Such methods, in particular, include physiotherapyMassage. In the absence of inflammation are useful exercises for stretching the palmar fascia. At night, it is recommended to wear a bandage langetnye. In some cases, treatment with prescribed medication. For example, when the local inflammation held injections of corticosteroids.

If the patient complains of pain, he appointedlocal anesthetic (eg, Novocaine) and glucocorticoid hormone (Kenalog 40 Diprospan, Hydrocortisone), which is inserted into the connective tissue area. These drugs can minimize the pain at the six to eight weeks.

Often, conservative treatment only slowsthe development of the disease. For this reason, after a certain time is still required surgical intervention. During the operation, the scar tissue is removed. Moreover, in the initial stages of nodules may be removed using aponeyrotomii, t. E. The needle. This operation is best done in the event that the angle between the palm and fingers injured less than 30 degrees.

Treatment proved to be quite effectivethrough a painless procedure like shock wave therapy. In this case, the device generates a wave, which is aimed at the focus of the disease. This effect causes positive changes in the affected tissue. Sometimes a fixed joint is formed so that the fingers cannot bend at all. In some cases, with overgrown connective tissue, which leads to compression of the nerves and blood vessels, it is recommended to carry out amputation of the finger.


Dupuytren's contracture, fingers, hands, ligaments

Due to the fact that the exact cause of the development of thisdisease is unknown, and prevention methods at the moment does not exist. To reduce the risk, doctors recommend how to address the effects of micro traumas of extremities as soon as possible. In addition, it is recommended to wear protective gloves when carrying out various works. More need to observe safety precautions. It is also recommended that enterprises implement tools that reliably protect your hands from possible damage. Patients who have gone through surgery, usually taken under medical observation.

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